PCL Knee Injury

PCL
knee injury is a serious knee injury. It can occur with contact sports
such as football or rugby, and can cause significant problems with the
knee. It is not nearly as common as an ACL knee injury, but just as
problematic.

What
is the PCL?

The
PCL, or posterior cruciate ligament, is one of the primary ligaments of
the knee. It runs from the posterior aspect of the tibia to the
anterior aspect of the femur. It crosses with the ACL within
the knee, which is where it gets the name cruciate, or to cross.

The
function of the pcl is to prevent the tibia from moving backwards under
the femur. It provides posterior stability. In contrast, the ACL
provides anterior stability, and keeps the tibia from moving forward
under the femur. Together the ACL and the PCL keep the knee stable.

The
PCL becomes most tight during full knee flexion. As you will see, this
is the most common way that it is injured during sports.

How
it is Injured

The most common way to injure the PCL is with
forceful flexion, or bending of the knee. The sports related PCL knee
injuries I have seen have all been with football players. They were
either fallen upon, or tackled, forcing their knees to bend very
forcefully, farther than they would normally bend. This forceful
flexion places great stress on the PCL, and can lead to rupture.

Another way
that the PCL can be injured is with a forceful blow to the front of the
tibia or lower leg. The amount of force needed to tear the PCL in this
manner is not common with sports...however, it is with car accidents. I
have seen several patients with PCL tears that were suffered during a
car accident, where their knee hit the dashboard, and caused their PCL
knee injury.

Symptoms of PCL Knee Injury

Swelling
and pain are the most common symptoms of PCL knee injury. Swelling
occurs almost immediately, within the first 10 minutes. This is because
of the very vascular nature of the PCL, and the fact that when injured
it bleeds quite a bit. It is located within the knee joint, so the
fluid is contained. The knee will swell up all around the joint, and
will look like a grapefruit.

As swelling occurs, this
increases knee
joint pressure, which causes pain. Much like other injuries, swelling
is responsible for many of the symptoms associated with the injury. PCL
knee injury is no different. Loss of motion and strength also occur, as
a result of the swelling.

Instability, especially
when moving from side to side, or rotating on the leg is common with
PCL knee injury.

Treatment

R.I.C.E. is the first step in
treating
a PCL knee injury Rest, ice, compression, and elevation is needed in
order to control swelling and pain immediately after injury. If you
have any of the symptoms above, you need to see your physician or
athletic trainer as soon as possible for further evaluation.

They
will take a history, and do some clinical tests to determine if you
have injured your PCL. They may also recommend you undergo an MRI for
further evaluation. You may have to be on crutches for a few days or
weeks depending on the amount of pain you are having. You may also be
placed in a knee brace to limit knee motion and allow the PCL to begin
to heal.

While
almost all ACL tears requre
surgery, most PCL tears are treated conservatively initially. The use
of a knee brace,
rest, and rehabilitation can be effective in treating
PCL knee injury. Focusing on improving the muscle function to help
staiblize the knee can be successful. Your physician may recommend a
derotation brace when you return to activity. Donjoy is one
manufacturer that has
I regularly
recommend these braces to my patients.

PCL tears may
need to be
surgically repaired, depending on your activity levels and your
symtpoms.

Summary

PCL
knee injury is a serious knee injury, although not terribly common. It
results from forced knee flexion, or a direct blow to the front of the
low leg. PCL tears produce swelling, pain, loss of motion, and
instability, and can be treated conservatively, but may require
surgical intervention. If you think you may have torn your PCL, you
need to see your physician or athletic trainer as soon as possible.

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